Introduction

Of course, just like with other questions about what’s normal when you have an ostomy, the answer may vary for each person.

In this post, I’ll go over various factors that can influence how often an ostomy bag may need to be emptied, as well as go over when to empty it.

If you are newly out of surgery, keep in mind that things will be a little crazy and your stoma may not be as consistent or predictable as it will eventually become with time.

Video

When Should You Empty Your Ostomy Bag?

Most ostomy nurses, supply manufacturers, and health websites will recommend that you empty your bag when it’s between 1/3 and 1/2 full.

This handy graphic should help to visualize when to empty your bag.

I happen to agree, although I often get lazy and empty my bag when it’s more than 1/2 full. I don’t recommend waiting until your bag is too full because there are plenty of reasons why this could cause problems:

It gets heavy. The weight of a bull ostomy bag is unwieldy and uncomfortable.

It gets bulky. Full ostomy bags are hard to keep concealed.

Leaks are more likely to happen. Really full bags can cause leaks because of pressure and tugging.

Emptying will be more difficult. I think most will agree that emptying 1/3 of a bag full is much easier than emptying 3/4 of a bag full!

Pouch deodorants will fail to work. There’s only so much a few drops of liquid pouch deodorants will be able to do. If you’ve got a really full bag then expect more odor from it.

Shit bombs aren’t fun! Ever have a two-pound bag of crap detach from your two-piece appliance and hit the floor? Let’s just say that it won’t be your proudest moment.

For me, the most difficult times to empty my bag are in the middle of the night because I can’t actively check my output while I’m asleep (no kidding, right?).

There are a few strategies to consider if you find yourself with a full bag at night or in the early morning.

Don’t eat or drink too late at night. Some people swear by the, “don’t eat after 6 pm” rule, but the results will be different from person to person and it depends a lot on your “transit time” (the time for food to pass through your entire digestive system).

Consider setting an alarm. Some ostomates will set an alarm to ring in the middle of the night so they can empty their bag before it gets too full. The disruption of your sleeping pattern may not be desirable.

Wear a larger bag at night or use a night drainage bag.

Consider medication to slow down your bowel movements. This should be discussed with your doctor, but you might be able to take something that will slow bowel movements for you at night.

Size Matters

Ostomy bags come in many different sizes, from teeny-tiny stoma caps (which really aren’t meant to hold any amount of output) to large, overnight drainage bags which are designed to hold several LITRES of output.

Obviously, the smaller the bag, the more often it’ll need to be emptied.

Many “large” bags (which are about 12″ in length) can hold about 650ml of liquid, but keep in mind that’s at maximum capacity. Smaller bags measuring 7″ may only hold 400 or 500ml of output at most, so at 1/3 full you’re looking at just over 130ml of output, which isn’t much.

I usually recommend wearing the largest size that’s comfortable to manage. That means if you’re only emptying your bag once or twice a day (i.e. you have a colostomy), there’s no reason to wear a large or XL-size bag. At the same time, if you find yourself constantly needing to empty your appliance, perhaps a small or medium bag is just not enough.

Type of Ostomy

Generally speaking, the higher up on your digestive tract your stoma is, the more output you should expect.

So someone with a jejunostomy would have more output than someone with an ileostomy. Likewise, someone with an ileostomy would have more output compared to someone who has a colostomy.

If you have a “short bowel” or have had a large part of your bowel resected, then your output frequency may be higher than normal.

Why does that happen? Well, mostly because fluids get absorbed further down (like the colon), so the more you’re missing the higher the volume of fluids will be passing through your stoma. This is why someone with an ileostomy or jejunostomy will usually have liquid output and a colostomate will often have a drier stool.

Some common expectations for various types of stomas follow below.

Colostomy

If you have a colostomy and irrigate your bowels, you might not need to empty your bag for a day or two! That’s pretty convenient! But if you aren’t irrigating your bowel then you may be emptying 1-3 times a day (or however often you would have been going to the bathroom before your surgery).

Ileostomy

Most ileostomates will empty their bag 4-10 times per day, but some may need to empty more often if they have liquid output. I find myself emptying around seven or more times per day, but I also let my bag fill up past the 1/3 mark.

Urostomy

A urostomy bag may need to be drained several times a day depending on the capacity. The volume of urine collected throughout the day should be closely matted with the volume of liquids you consume. A urostomate who drinks several liters of water should expect several liters of output in a 24h span.

What You Eat and How Often You Eat It

“What goes in must come out” is a nice adage that perfectly illustrates this point.

If you’re a coffee drinker, you may already notice that your stoma will be more active than when you aren’t drinking coffee. This may also true for people who drink red wine or fruit juice. Consider cutting back on foods and beverages that cause excess output if it’s something that worries you.

It also goes without saying that the greater the volume of food and beverage you consume the more output you will have. This is especially true if you’re eating fibrous, plant-based foods (like I do). If you find that eating plant-based foods cause your stoma to go wild, cut back on the amounts you’re eating in a single meal to help spread things out.

Some ileostomates and colostomates may change their diet a little to include more starch-based foods (i.e. potatoes, rice, etc.) to help slow down their bowel movements. This can be used as a long-term solution, provided you’re eating healthy foods and not only potato chips.

For a list of foods that may increase your output, check out THIS article.

Other Factors

Several other factors could influence how often you’re emptying your appliance.

For example, if you are on antibiotics, you may notice that your bowel frequency is increased along with a change in the consistency of your output. This is considered a normal side-effect that often resolves itself after you’ve finished taking them.

I also tend to get a huge change in the frequency and consistency of my output when I have the flu or a cold.

Some, or all of these, may cause a change in your bowel habits:

Stress.

Cancer treatment.

Antibiotic use.

Food poisoning.

Medication or supplement side-effects.

Active disease.

Motility disorders.

Should You Worry?

There are a few instances where I would be concerned about the frequency of my output. Of course, always talk to your stoma nurse or doctor if you have any concerns.

Emptying Too Often

If you find yourself emptying your bag far more than have been in the past, check to see if your diet has changed recently. Even small changes in our diet can influence our bowel transit time – at least in the short-term.

If it hasn’t, I would generally wait to see if things settle down after a day or two. Sometimes, frequent stoma output tends to resolve itself without me even knowing the cause.

But if bowel movements have been increased over many days or weeks, I’d schedule a Dr’s appointment to investigate this further.

Not Emptying Enough

When I notice that I’m not emptying my bag as often as I should be in relation to the amount of food I’m consuming, the first thing I’ll do is make sure I’m getting enough fluids. Dehydration can slow things down considerably.

I’ll also try to note whether I have any pain or discomfort around my stoma, which often indicates a partial blockage.

Sudden Changes

Most short changes in bowel frequency aren’t usually a cause for concern, but if you notice any unusual or sudden changes that seem to be persistent then it’s important to monitor things more closely.

Always let your doctor or stoma nurse know of sudden changes to your bowel habits as it may indicate disease activity, which is something you’ll want to be addressed quickly.

Conclusion

As you can see, there are many factors that play a role in determining how often you’ll be emptying your ostomy bag.

While there are certain things that can make it more predictable, such as the volume of food you’re eating, expect to find your new normal after several months past surgery.

Question: What type of ostomy do you have and how often do you empty your ostomy bag?

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Miriam, I just re-read you question. I want to add, that on occasion when Rose has a day or two off, this does happen. But, be aware of what you eat and when, and then also if what you passed before yours became quiet, has it been in the bag or not. Write it down if need be to keep track. I can tell this by colour usually. Milk will be creamy when had with a meal…V8 juice will be dark orange Beets will be pink or purple. Not to be mistaken for blood even in urine. If your bowel is on the empty side, it can take time to fill again and then work. But, also always be aware of a possible blockage. Eric has a video on blockages I believe. I get blockages a lot, and they are not fun. Painful, so it is good you are aware of what is going on. As soon as I notice a change I did not cause I try and keep track of my input, and output and also when she rolls again after a stop I caused. For me the first sign of a blockage is a quiet stoma, unless I have been out and caused it for more then one day especially if I have eaten less, or little to none. We flew to Hawaii five months after my stoma and I was terrified of the flight time. I did not want to wait in the washroom lineup at all. So I only ate once there, and very little the day ahead, but always drinking water or juice. It worked just great, but I really got things going again when on land. I am 60. Had Rose since 2008. Is this more what you need to know?Linda

Miriam…I do the same thing when I have to leave the house. I eat smaller, more nutritious, meals the day before and hydrate well, and then the morning of going out, I may have a glass of milk with my pills, and then I only eat on the way home or once home. I also always carry water with me and drink water when out. Going out two days in a row, I try to avoid, just due to eating less, as it does mean very little output. Rose (my stoma) is very active all the time and I can be in the can every forty minuets. So going out and being in the bathroom often does not mix well. Your stoma is likely to produce what you put in. Mine will normally be busy as soon as one to three hours after eating. Eating less produces less and so forth. That is normal for me. Sometimes after not eating much if any for two days, she slows right down and produces only small fluid. If I have a fever she produces less all around so I watch for constipation or blockages then. V8 juice is great to drink when out and about. Does this help you any? Linda

Reply

3 months ago

Guest

Miriam channkowsky

I wanted to know if it is normal not to have any out put in two days. The first day I ate very little because I was going to an event and didn’t want to have to empty my bag there which I didn’t and then the next day I didn’t have to empty anything again. Could this happen and is it ok not to go in 2 days though I may go tonight which is the 2nd day.

I often rinse my bag clean with water and haven’t noticed any ill effects. I will caution you on two things: If your appliance already has a small leak forming, the water will make it worse. And if you have a filter on your bag, it may become clogged if the water reaches it.

I would suggest using a small amount of water and try not to have it reach the stoma. As a general rule, if I notice that the water is cold around my skin, it’s probably breached the barrier and I don’t rinse anymore with that appliance.

TK Koh and Gary Archie…welcome to this very helpful sight. You will find Eric to be very helpful and teach things that I know I had no clue about, even after my 10 years or so with my ostomy. Such as being able to get samples from other companies, (they will want your business), so you may find them helpful also. Ask questions and more questions. One thing we have found and it was something I did right way was to name my stoma. I call her Rose because she really is a beautiful thing. Giving it a name does help to identify with our new little friend a lot easier. There was actually a chat about this a while ago. Check our recent posts and forums in the headline. The names are creative, so have some fun. Most stomas have their own personality. I changed Roses name 3 times before I settled on Rose. Your questions are some of what I had actually thought to ask my surgeon and my nurse after surgery. Yes, it is safe to rinse out your pouch that you have on. I prefer to do this as when you just empty it, you still have to close it and then cleaning the mouth of the pouch can be a fussy time consuming job. I use a flat one piece pouch and also secure it with the elastic barrier tapes, (there are now 2 sizes…get samples) because I do a lot of bending. I also keep two plastic cups by the throne and rinse once or twice as needed. I can give it a good bit of a wiggle to rinse, but if you have a 2 piece, you will have to be more careful. When I am away from home I carry a bottle of water with me labeled Bag H2O to rinse it when I am out, refillable and washable, recyclable. I use a deodorant called M9 in the bag, 18-20 drops and this does help immensely with odor. Eric has a video on this I am sure. Hollister makes it. One thing I also asked, being concerned about parasites and what have you in water, I asked if anything can get into my stoma. I was told a definite- NO, nothing in, only out. I had previously battled a year and half fight with Cryptosporidium…that was just nasty! So you can see my concern with rinsing. No question is a bad question here. It may take a few days, but you will get replies if someone can help or just welcome you. Let us know what you name your stomas. Stay well and hydrated.

Chris, Be very careful when you approach the surgeon. You might get in trouble with Child Protective Services or similar agency. As much as we stand up for each and help each other and etc. , we all have been surgically altered. IT WAS NOT AN OPTION . IT WAS MEDICALLY NECESSARY . IT WAS NOT FOR FUN OR CONVENIENCE! If this was an April Fools joke , I was had. If it was for real, DON’T DO IT.

Never thought of the Child protective service.. !!!!!!!! Your right Z.. One eye or slipped word can get you in lots of trouble.. OR reported by family member, so called friend.. A friend of mine had this done for her husband tho, Wanted to keep him home and NOT in a nursing home.. If this teenage is having multiple changes, he may have colon issues–so maybe start there.. but don’t say YOU want this — it may be down the road for him any ways.. ??? Talk with a few upper and lower GI Doctors.. Go slow!! Eric, has a blog for the proper words on this subject to learn so, you can have some smarts and proper questions on the subject.. As you may have already read, they may put him on medications which can make this child sicker and produce more diaper changes………. Learn the medications affects.. From what I have read, they are not nice !! This GIFTED CHILD has issues in the first place, Meds can turn your and his world upside down and around….. His temperament for one.. Best. M.

Hello Chris . Welcome to the forum . I agree with Eric and Marcie . I have an Ileostomy not a colostomy so a little different . But there were different things to deal with after and since my surgery that I was not aware of before having my surgery . I understand what your concern is with your son but definitely would suggest doing your homework on this first . Maybe you could check around the area where you live and see if there is an Ostomy support group that you could sit in on a meeting or two with and get a face to face discussion with someone who has one . Before seeing a surgeon .

Reply

8 months ago

Guest

chris

Hi all: We’re considering a colostomy for our teen son with severe special needs. He can’t walk but can stand with assistance. He wears a diaper full time and has small bowel movements all day, 5-6. We are feeling like a colostomy would make life easier for him and us. But we’re not sure. We keep him very clean and change his diaper often, but are thinking that a bag empty every few hours would be a lot easier on him and us while changing his wet diaper. Any thoughts welcome.

I’d be interested in knowing what a surgeon thinks of this. To be honest, I don’t believe any surgeon would give your son an ostomy out of convenience, but I can see how it might appear to be a better option for you and your son.

Keep in mind that an ostomy can come with its own risks, and if your son developed any skin or stoma problems, it’s very likely that it would make life more difficult for you compared to now.

But I do think you’d have to provide an overwhelming case before any surgeon would consider it (and I don’t think they would unless the colostomy was a medical necessity).

Hi Guest Chris, If you decide along with your surgeon, I agree with Eric, but first, I would, if this was my child, try out different waffer’s on his belly, just to see if any reactions… and a pouch on him to see how he reacts. This will be a learning account for everyone.. This is a new future for you all and mostly your dear son. I hope you really read everything Eric and the rest of us put on this blog……. We who have ostomy’s here have issues being ostomy’s…….. Just because….. I am sure you have it hard already– and this just may help– but be ready.. EDUCATION IS THE KEY POINT HERE . Remember, there is NO control of bowel movements of this.. IT is the gift that keep on giving.. shall I say.. :-) I wish you and your son the very best in the future.. and GOD Bless. M.

Reply

8 months ago

Guest

Paul Wooster

Please, what is a night drainage bag? My dad has a colostomy bag and has to keep getting up every 2 hours in the night to empty it. Any suggestions? Thank you.

Unfortunately, it really only works with Coloplast systems, but other companies may offer something similar to that. Alternatively, “high-output” or XL pouches may also work. These tend to come in 1100ml+ capacities and stay attached to your abdomen.

I’m working on a new article/video on some newer high-output bags by Coloplast, which I will try to get done in the next week or two.

That sounds wonderful! Did it take long to get to that point or did it happen pretty quickly?

Reply

1 year ago

Member

Krishnapriya

Hi Eric, Thanks so much for sharing this info! Your links have given me a wealth of detail. I just recently had a total pelvic exenteration done because of uterine sarcoma.. so I now have a wet colostomy – both urine and stool coming out of a single stoma coming out of the end of my large intestine. I am still trying to figure out what works best for me.. I have tried coloplast flanges and their urostomy bags – which are quite conveniently large and also capable of expelling solid waste.. and now I am trying convatec just for the incredible advantage of mouldable flanges.. in convatec and coloplast, I find that the colostomy bags get full really fast, because of my wet colostomy and I end up draining every hour or so during the day, and every two hours at night, which is quite irritating. So I recently tried the convatec high output bag – that’s a bit better.. but I keep wondering – if the bag is bigger, doesn’t the increased weight of a corresponding third of the bag cause greater tugging on the flange? What bags do you recommend for a wet colostomy? Also what do you think of bigger bags and their tugging on flanges? Thanks a ton again for the great info!

I’ve had an ileostomy for 19 years. It’s a part of me and yeah, sometimes I have a blow out but all in all it was the best thing that happened to me after 10 years of ulcerative colitius. I empty every time I go to the bathroom unless very little is in there. It’s just a routine that I always do. I usually eat late (after 7 or 8 pm) so I get up once in the middle of the night to go to the bathroom and empty. No big deal. Just part of the routine.

I am up late. My appetite is large and I am never full. I ante a salad (not very large–would NEVER DO PANERA!!!WHAT A MESS THST WOULD BE AND THEIR SALADS ARE TOO LARGE EXCET FOR THE SIDE SADLAD IN YOU PICK TWO) I have tried everything except keeping a notebook log and I have enough trouble doing what I need to. My surgeon told me to do Metamucil and I do so my output is thicker during the day. I am afraid to take it before I go to sleep. I have been very upset in light of what happened in the US and the crap coming out of 45’s mouth supporting White Supremacists and my bag is puffy which I assume is gas. I sleep through the night but I am on Disability and cannot work so my sleep patterns are irratiic and I am very hungry late at night. I am trying veggies but my Stoma Nurse said nothing raw, and peeled and steamed well if fresh and very steamed if frozen. I do have a delima. I eat thickeners, peanut butter, bananas & mashed frozen potatoes from Trader Joe’s that are thick circles and you can make as many as you want. Because I cannot eat flaxseed meal, chia seeds, hemp hearts, and raw nuts and big salads I am going nuts but I do not want a blockage. Also, I hardly ever left my large Hollister bag (12″) get more than a third full. I was drinking Gatorade as it was recommended fir the potassium & electrolytes but cut back due to the Cook County (Chicago & suburbs in Cook Cpunty) sweetened beverage tax and a penny an ounce. I do drink a lot of water. I am thirsty, especially in the hot weather. I do not know how to eat like I did and I cannot lose the weight I gained. Sorry this was long and your BIRTHDAY IS DURING THE ECLIPSE ON MONDAY!! How auspicious!! Congratulations! Any suggestions?

Is your hunger being caused by any medication you might be on? Like steroids? If so, then it can be quite a challenge and changing your eating habits alone may not help much for hunger. If it’s not related to medication then you may have better luck eating higher protein foods as they tend to be natural at curbing appetite. For me, that might be something like tofu, or “textured vegetable protein” added to meals, or even beans.

Changing my schedule won’t work for me because of a very good reason, I am back to work! I’d rather have the increased output when I’m at home and sacrifice some sleep. It’s bad enough that after lunch I’ll be in the ladies room frequently.

Also I am trying a new food each weekend to see how my output is affected. So far so good, I just miss Panera salads. Once I’m healthy that’ll be the first thing I eat. :-)

Thank you for highlighting this! My emptying amounts vary. I’m doing much better at night lately because I don’t eat after 7. I’ve actually had nights with 3-4 solid hours of sleep without interruption!

I’m glad that been working for you! Some people will move their largest meals to breakfast and have smaller meals for lunch and dinner. That strategy may work for you, but it does take some adjustments as you may not like big breakfasts!

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